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Editorial

Marraige and Family


""Are You Being Chased by the "Black Dog"?Understanding, Diagnosing and Treating Male DepressionPart 2


07/01/2007 - Last month, we discussed some of the symptoms of depression in men. In this article, we will take a look at some more of the differences in how depression manifests itself in men and women and how men mask their depression making it very difficult to identify. Dr. Archibald Hart in his book Unmasking Male Depression suggests that it is advisable to pay attention to a woman's feelings while it is more likely for men to act out their depression (behavioral rather than emotional). Often, women will tend to be sad and try to "connect" with friends or take care of someone else which Dr. Hart calls the "tend and befriend response". Men, on the other hand, tend to vent their frustration and anger when depressed and they become moody and irritable. They more often withdraw rather than connect, and retreat into their "caves", giving those around them the silent treatment. Another way to describe the difference is that women are more often overt while male depression has a tendency to be more covert. Men have basically the same feelings women do when they are depressed. However, the symptoms of depression have been "feminized" making it very uncomfortable for the man who is depressed to identify with those symptoms.

Consequently, many men simply try to "mask" their depression to comply with perceived societal expectations. There are a variety of masks that they employ in their cover-up. These are utilized to distract and numb or "medicate" the feelings that many men cannot acknowledge. Dr. Hart has described four of these masks:

1)Anger, Rage and Pent-Up Resentment: I have seen many angry adolescents and men of all ages who come across as mean, rebellious, hard to get along with, grouchy, negative, bitter, and a number of other negative adjectives. If I get past the anger in working with one of these males, there will often be sadness and even tears. Dr. Hart suggests that when there is extreme rage and violence (e.g., Columbine High School, domestic violence, etc.) it is likely that the underlying cause is extremely severe depression.

2)Workaholism:Work can become a major distraction and the results are sometimes both cause and effect. Working too much and taking on so much that the result is increased stress, which effects the body's biochemistry (specifically, it lowers serotonin levels causing depression). In the same way, work also is used by some to distract them from their depression.

3)Avoidance of intimacy:Emotional connection is the last thing a depressed male desires. Therefore, he may be cold, indifferent and completely detached. Not only that, he will often begin to blame others for why he feels so bad it couldn't be inside of him that causes him pain and sadness. When we talk about intimacy avoidance, it may or may not involve a man's sexual desire. For some men, the sex drive is diminished for others, it is not.

4)Sexual Compulsions:Again, Dr. Hart suggests that only severely melancholic and depressed men lose their sexual desire. Many men use sex for a temporary but effective way to feel better for a little way. This can result in an increased demand for intercourse. However, some men may use pornography, masturbation, phone sex, and cyber-sex to distract and medicate their sadness and pain.

If you or someone you know is manifesting these masks and distractions, there is a good chance he is experiencing depression. An evaluation by a medical professional and a mental health professional could be extremely helpful. The research indicates that the most effective treatment for depression involves therapy to help sort through thoughts, feelings and behaviors and at least in some cases, there may be the need for antidepressant medication as well.

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